| Title |
Cost-effectiveness of tiotropium versus glycopyrronium in moderate to very severe chronic obstructive pulmonary disease in Canada, Spain, Sweden, and the UK
|
|---|---|
| Published in |
ClinicoEconomics and Outcomes Research: CEOR, June 2016
|
| DOI | 10.2147/ceor.s105579 |
| Pubmed ID | |
| Authors |
Oskar Eklund, Faraz Afzal, Fredrik Borgström, Jason Flavin, Andrew Ternouth, Maria Eugenia Ojanguren, Carlos Crespo, Mike Baldwin |
| Abstract |
Tiotropium (TIO), Spiriva® Handihaler®, is a well-established bronchodilator, LAMA (long acting muscarinic antagonist), for the treatment of moderate to very severe chronic obstructive pulmonary disease (COPD). Clinical evidence from the SPARK trial suggests that TIO is superior to glycopyrronium (GLY), Seebri® Breezhaler®, in terms of severe exacerbations. This modeling study assessed the cost-effectiveness of TIO versus GLY for Canada (CAN), Spain (ESP), Sweden (SWE), and the UK, making use of this new clinical evidence. A Markov cohort model, with moderate to very severe (Global Initiative for Chronic Obstructive Lung Disease II-IV) COPD patients, was populated with efficacy data from the Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT) and SPARK trials as well as costs, utilities, and epidemiological data relevant for each country. Treatment efficacy was modeled as improvements in lung function, quality-adjusted life years (QALYs), and as a lowering of the risk of exacerbations (rate of exacerbations). Risks of exacerbations differed between cohorts based on data from SPARK. Health and cost outcomes were simulated over an approximate lifetime horizon, starting from the age of 65 years. Robustness of results was validated in deterministic sensitivity analyses. Over the lifetime horizon, patients treated with TIO accumulated -623 (CAN), 1,066 (ESP), 1,137 (SWE), and -169 (UK), respectively, in incremental costs (€2014). TIO generated better health outcomes compared to GLY in all countries, 0.21 (CAN), 0.25 (ESP), 0.23 (SWE), and 0.23 (UK) in incremental QALYs. The cost per QALY gained was found to be €4,281 and €1,137 for ESP and SWE, respectively, while TIO was found to be cost saving in CAN and the UK. The results were mainly driven by the relative risk of severe exacerbations found in SPARK (GLY/TIO relative risk: 1.43, 95% confidence interval: 1.05-1.97, P=0.025). The results from this study show that TIO is a cost-effective treatment compared to GLY in moderate to very severe COPD. The cost per QALY is well below the existing implicit and explicit willingness-to-pay thresholds. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 40 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 40 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 8 | 20% |
| Researcher | 7 | 18% |
| Other | 6 | 15% |
| Lecturer > Senior Lecturer | 2 | 5% |
| Student > Doctoral Student | 2 | 5% |
| Other | 8 | 20% |
| Unknown | 7 | 18% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 13 | 33% |
| Nursing and Health Professions | 6 | 15% |
| Biochemistry, Genetics and Molecular Biology | 4 | 10% |
| Pharmacology, Toxicology and Pharmaceutical Science | 4 | 10% |
| Economics, Econometrics and Finance | 2 | 5% |
| Other | 3 | 8% |
| Unknown | 8 | 20% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 October 2019.
All research outputs
#7,811,404
of 25,457,297 outputs
Outputs from ClinicoEconomics and Outcomes Research: CEOR
#167
of 525 outputs
Outputs of similar age
#116,002
of 353,828 outputs
Outputs of similar age from ClinicoEconomics and Outcomes Research: CEOR
#9
of 24 outputs
Altmetric has tracked 25,457,297 research outputs across all sources so far. This one has received more attention than most of these and is in the 69th percentile.
So far Altmetric has tracked 525 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.0. This one has gotten more attention than average, scoring higher than 66% of its peers.
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We're also able to compare this research output to 24 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 54% of its contemporaries.